Kevlar for the Mind: 'Disorder' is proper label for post-traumatic stress

Apr. 2, 2014 - 01:33PM
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In the brewing battle over the issue of changing the term “post-traumatic stress disorder” to simply “post-traumatic stress,” the opposing forces are powerful and convincing in their own rights.

The side that believes the “D” should be dropped from PTSD includes former President George W. Bush, retired Army Gen. Pete Chiarelli and a number of veterans groups. On the other side is the formidable psychiatric community that controls the Diagnostic and Statistical Manual of Mental Disorders — the reference publication that lists the diagnosis.

There is no absolute right or wrong answer.

Those who support dropping the “D” believe that would reduce the stigma associated with seeking help for PTSD, thus increasing the number of troops who come forward for treatment. They also believe characterizing the current disorder as an “injury” would change public perception and lead to greater acceptance of the traumatized men and women who reintegrate back into their communities after combat.

Those against the name change cite reasons that resonate primarily in academic and professional circles, but are nonetheless relevant and important. Categorizing symptoms into a distinct and uniform disorder allows researchers to determine which treatments work, identify those most at risk for developing the disorder, and possibly develop methods for preventing it.

As a psychologist with ties to the academic and professional psychiatric circles and as a veteran who sought help for post-traumatic stress, I see the merits of both sides. Ultimately, however, I believe simply changing the name of the disorder will do little to increase access to care for troops or change the perceptions of the public.

There is little evidence to show that service members do not seek help for PTSD because of stigma. In fact, the Veterans Affairs Department is encountering record numbers of disability claims for PTSD, even though the prevalence of the disorder among post-9/11 veterans of Iraq and Afghanistan is equal to or less than previous conflicts. And to my knowledge, there is no evidence indicating that a name change will cause more men and women to come forward.

Conversely, the unintended consequences of a name change could be dire. For one thing, comparing PTSD to a physical injury such as an ankle sprain could minimize its seriousness. If that happens, troops may be embarrassed to seek help, considering they live in a culture that embraces a “suck it up and drive on” mentality. In addition, a shift in the general public’s perception toward PTSD could lead to less acceptance as well as reduced funding for research and treatment.

Both possibilities would be an injury to the progress we’ve made over the past several decades in understanding PTSD.

Bret A. Moore is a clinical psychologist who served in Iraq. Email kevlarforthemind@militarytimes.com. Names and identifying details will be kept confidential. This column is for informational purposes only. Readers should see a mental health professional or physician for mental health problems.